Gender differences in the prevalence of airway hyperresponsiveness and asthma in athletes

Respir Med. 2009 Mar;103(3):401-6. doi: 10.1016/j.rmed.2008.09.023. Epub 2008 Nov 21.


Background: Although athletes have a high prevalence of airway hyperresponsiveness (AHR) and asthma, little is known about possible gender differences in regard to these features. We looked at the comparative prevalence of AHR, physician-diagnosed asthma and respiratory symptoms during exercise in female (F) and male (M) athletes.

Method: A retrospective analysis was done on 2 groups of athletes: Group 1 (n=100) taking part in a study on the prevalence of AHR to methacholine (PC(20)<16mg/ml) and Group 2 (n=698), taking part in a provincial survey on the prevalence of physician-diagnosed asthma. Subjects from both groups filled the same questionnaire on respiratory symptoms during exercise (breathlessness, wheezing and chest tightness).

Results: In Group 1, prevalence of AHR was significantly higher in female (60%) compared with male (21.5%, p<0.0001) athletes despite a similar prevalence of physician-diagnosed asthma (F: 17.1%, M: 15.4%, p>0.05). Respiratory symptoms during exercise were more frequently reported in females (37.1%, M: 16.9%, p=0.02); however, when corrected for the PC(20), this difference became non-significant. In Group 2, the prevalence of physician-diagnosed asthma was not different between genders (F: 12.5%, M: 14%, p>0.05) but respiratory symptoms during exercise were more often reported in female (19.4%) than in male (12.2%, p=0.01) athletes.

Conclusions: This analysis shows a higher prevalence of AHR and exercise-induced respiratory symptoms in female compared to male athletes, but a similar prevalence of physician-diagnosed asthma. This suggested that the increase in respiratory symptoms in female athletes failed to translate into a higher prevalence of physician-diagnosed asthma.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Asthma / diagnosis
  • Asthma / epidemiology*
  • Asthma / physiopathology
  • Bronchial Hyperreactivity / diagnosis
  • Bronchial Hyperreactivity / epidemiology*
  • Bronchial Hyperreactivity / physiopathology
  • Bronchoconstrictor Agents
  • Chi-Square Distribution
  • Exercise / physiology
  • Family Practice
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Hypersensitivity / complications
  • Hypersensitivity / diagnosis
  • Male
  • Methacholine Chloride
  • Prevalence
  • Retrospective Studies
  • Sex Factors*
  • Sports / physiology*
  • Surveys and Questionnaires


  • Bronchoconstrictor Agents
  • Methacholine Chloride